Little is known about the oral health of American blacks. In particular, have they experienced the same reductions in dental caries and improvements in oral health as has the majority culture during the past several decades? A contemporary series of patient records (n = 300) was examined to test for age, sex, and race (American black and white) differences in an urban Midsouth population. Tooth loss was strongly age progressive in blacks and whites, but the rate was much greater in blacks. Periodontal probing depths also tended to be greater in blacks, particularly for the maxillary anterior teeth. The pattern of tooth loss with age in blacks is similar to rates recorded for the whole United States in the early 1960s. Subsequently, whites have tended to experience substantial improvements in oral health (ie, fewer decayed, missing, and filled teeth and less tooth loss); blacks in this sample have not exhibited this improvement.